When you’re at risk for gout pain, your favorite foods and drinks can be your worst enemies. Fortunately, there are also plenty of anti-gout eats that prevent attacks of this inflammatory arthritis condition. Ready to trade beer and shellfish for coffee and nuts? Read on to learn what you should be eating more of, and what to keep off your plate to avoid pain and discomfort...

One night after a satisfying feast, you wake up with a really grouchy big toe – inflamed, throbbing and red. Your life with gout pain has begun.

The condition, a form of inflammatory arthritis, is largely hereditary and mostly strikes men over 30. But women are also at risk, especially after menopause.

Gout is caused by excess uric acid, a useless byproduct of dead cells. Once uric acid builds up in blood, it forms needle-like crystals that lodge around joints and even in soft tissue, creating excruciating pain.

Uric acid is also formed from purines, compounds in certain foods, especially organ meats. Although dietary changes alone aren’t enough to banish gout pain attacks, it’s still important to eat anti-gout foods, while avoiding those likely to sabotage your body.

A gout-friendly diet not only lowers the risks and severity of attacks, but can also diminish other disorders that accompany it, such as obesity, high blood pressure and diabetes, says Kelly O’Connor, R.D., diabetes educator at Mercy Medical Center in Baltimore.

But first, identify your problem snacks.

“Most patients have their own set of foods that trigger attacks,” says Harris H. McIlwain, M.D., a rheumatologist in the Tampa Medical Group in Tampa, Fla., and co-author of Diet for a Pain-Free Life (Da Capa Press).

Still, it’s clear which foods are most likely to cause gout, and which can help reduce your risk. Here are the ones you need to know about.

“Alcohol is worse than most foods,” says rheumatologist Frank Arnett, Jr., M.D., a professor at the University of Texas Medical School in Houston.

That’s because all alcohol lowers the blood’s pH level, or its acid-alkaline balance, which helps cause uric acid to crystallize.

“More than two drinks a day are likely to precipitate a gout attack,” says Zorba Paster, M.D., clinical professor in the University of Wisconsin’s School of Medicine and Public Health in Madison.

Alcohol is also dehydrating, which limits excretion of uric acid and increases the risk of kidney stones, more common in those with gout, says Lanah J. Brennan, R.D., certified diabetes educator with a private practice in Lafayette, La.

If you do drink, stick to wine, because beer is especially likely to cause gout attacks. Its yeast is high in purines. (Don’t overdo yeasty breads either.)

Pro-gout food #2: Organ meats.Some consider foods, such as liver pâté and calves’ sweetbreads (the thymus gland, pancreas and kidneys) to be delicacies. But they’re bad news for gout sufferers because they’re loaded with purine.

While there’s little research on women, men who ate meats with the highest purine content had a 40% higher risk of gout than those who ate the least, according to a 2004 study of more than 47,000 participants tracked for 12 years at Massachusetts General Hospital and Harvard University.

Pro-gout food #3: Beef and pork. Although organ meats are worst, most meats are moderately high in purines, Dr. Arnett says.

Eat no more than 4-6 ounces of lean meat or fish per day, O’Connor recommends.

“A standard serving of red meat is about 3-4 ounces, [about the size of] a deck of cards,” she says.

Pro-gout food #4: Shellfish. It’s best to take high-purine items like shrimp, lobster and scallops off the menu.

Men who ate the most seafood were 50% more likely to develop gout than those who ate the least, the Harvard study found.

Pro-gout food #5: Fatty fish.
Other finned creatures should be limited as well. Anchovies, herring, redfish (ocean perch), sardines and tuna are among proteins that cause gout pain and should be limited to 4-6 ounces per day.

Pro-gout food #6: Sugary sodas.
Gout risk was 74% higher among women who drank a serving of sweetened soft drinks each day than those who drank less than one serving per month, a 2010 analysis of the 79,000-participant Nurses’ Health Study found. Diet soda didn’t cause gout to rise.

Fruit juice and high-fructose fruits, such as apples and pears, also create a higher risk of gout pain. Fruit has many health benefits, but go for lower-fructose items such as berries and stone fruits like apricots and nectarines.

What You Should EatAnti-gout food #1: Tofu. “For those who are carnivores and miss meat, consider tofu instead,” suggests Nathan Wei, M.D., director of the Arthritis and Osteoarthritis Treatment Center of Maryland in Frederick, Md.

Water’s your best bet since it’s calorie-free and almost always available, Brennan says. For a touch of flavor, add lemon and lime slices to a pitcher you keep ice-cold in the fridge. And always have a bottle to drink in the car and at your desk.

Anti-gout food #3: Cherries. “Dark berries have a powerful anti-inflammatory effect and the best are cherries,” Dr. Wei says.

Like blueberries and strawberries, they contain anthocyanins, anti-inflammatory plant pigments – the darker the berry, the more you get.

Wei recommends eating one-half to 1 cup of cherries or dark berries per day. You can also drink cherry juice or take cherry supplements in capsule form (as directed on the package).

Anti-gout food #4: Nuts.
A handful (or 1/4 cup) of almonds or walnuts is a good meat substitute for those at risk for gout pain, says O’Connor. Nuts don’t contain any purines, so they minimize the threat of an attack.

So spread a little peanut butter on whole-grain crackers for lunch.

Although nuts are high in fat, it’s mostly the healthier unsaturated kind. And both the fat and whole grain satisfy you longer, which keeps your waistline trim.

That’s because low-fat dairy significantly lowers uric acid levels, according to several studies, including a 2005 analysis of the CDC’s Third National Health and Nutrition Examination Survey (NHANES). The researchers speculate that two dairy proteins – casein and lactalbumin – increase uric acid secretion.

Low-fat dairy also is a good way to get protein into your diet. A three-quarter cup serving of 1% cottage cheese has 21 grams of protein and only about 122 calories.

Anti-gout food #6: Legumes. Lentils, peas and beans are high in purines, but they don’t cause gout risk to rise, according to the 2004 Harvard study.

Beans are low in fat and high in protein and fiber, so they reduce saturated fat intake, which could be partially responsible for gout.

Anti-gout food #7: A cup of java.
Drinking coffee may lower your gout risk, according to a 12-year 2007 Canadian and American study of 46,000 men.

In fact, the more coffee men drank, the more their uric acid levels fell – they were 40% lower in those who drank 4-5 cups a day.

Although no one’s recommending you gulp coffee by the gallon, your morning habit could help prevent gout pain.

Anti-gout food #8: Vitamin C-rich vegetables and fruits.
Most fruits and vegetables are low in purines. O’Connor says. What’s more, men who took in at least 1,500 milligrams (mg) of vitamin C per day had a 45% lower risk of gout than those who got less than 250 mg, according to the Canadian-American research.

Foods high in vitamin C include oranges, grapefruit, broccoli and red peppers.

Popping a supplement might be easier, but talk to your doctor about the dose. Too much vitamin C could increase uric acid levels or even trigger a gout attack by causing rapid shifts in uric acid, Dr. Wei says.

Anti-gout food #9: Pineapple. Pineapple has bromelain, an enzyme that reduces inflammation and pain, Dr. Wei says. Eating a half-cup per day can help when gout pain ratchets up.

Anti-gout food #10: Foods high in omega-3 fatty acids. This may sound contradictory, because people who have or are at risk for gout should avoid eating too much fatty fish like salmon and mackerel. But moderate amounts – no more than 4-6 ounces per day – provide omega-3 fatty acids, which are powerful anti-inflammatories, Dr. Wei says.

You can also get omega-3s from flaxseeds. Sprinkle a tablespoon a day on cereal or stir-fry.

How Much Do You Know About the Types of Arthritis? About 46 million American adults – nearly one in five – suffer from some type of arthritis. It’s estimated that number will rise to 67 million by 2030. Do you or someone close to you have arthritis? Take this quiz to see how much you know about this disease.

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